HomeMy WebLinkAbout2017-08-16 Cross Connection Control Device Performance Test Report - Interstate Testing 2017.08.18 04:29 PM Interstate Testing 7637555365 PAGE. 20/ 20
��„ Cross Connection Control Device Performance Test
Interstate Testing
2140 141st Ave.NW.
Andover Mn.55304
Phone(763)7444149
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I HEREBY CERTIFY THE TEST RESULTS ARE TRUE AND THE TEST WAS CONDUCTED BY ME PERSONALLY%
Tooter Name(print) D°Ay*)•. /I 1 f 1'e a ReMst ation No.C,6 C3-13 3 1 nrae of Day
Tester Signature(/opt fril-e— Phone No.762 3 Date J//a/7